Skip to main content Accessibility help
×
Home

Individual and food environmental factors: association with diet

  • Mariana Carvalho de Menezes (a1), Ana Victoria Diez Roux (a2), Bruna Vieira de Lima Costa (a1) and Aline Cristine Souza Lopes (a1)

Abstract

Objective

To examine the associations of individual and food environmental factors with fruit and vegetable (F&V) intake in a city in a low-to-middle-income country (LMIC).

Design

Cross-sectional.

Setting

Representative sample of the Brazilian Primary Care service known as the Health Academy Program (HAP) in Belo Horizonte, a Brazilian city.

Subjects

Using a conceptual model as a guide, individual and food environment data were obtained through: (i) face-to-face interviews with participants aged 20 years or older; and (ii) F&V food store audits. A broad set of individual, household, and community and consumer nutrition environment variables was investigated. Multilevel linear regression was used to quantify area-level variations in F&V intake and to estimate associations with the factors.

Results

Eighteen HAP centres were selected and 2944 participants and 336 food stores were included. F&V intake varied between contexts, being higher in areas with better socio-economic conditions and food store quality, such as specialised F&V markets. Individual-level factors, including age, income, food insecurity, stage of change, self-efficacy and decisional balance, were significantly associated with F&V intake. After controlling for individual-level characteristics, greater F&V intake was also associated with higher quality of food stores.

Conclusions

In one of the first studies to comprehensively assess the food environment in an LMIC, individual-level factors accounted for the largest variation in F&V intake; however, the food environment was also important, because area-level variables explained 10·5 % of the F&V intake variation. The consumer nutrition environment was more predictive of healthy eating than was the community nutrition environment. The findings suggest new possibilities for interventions.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Individual and food environmental factors: association with diet
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Individual and food environmental factors: association with diet
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Individual and food environmental factors: association with diet
      Available formats
      ×

Copyright

Corresponding author

*Corresponding author: Email alinelopesenf@gmail.com

References

Hide All
1. Forouzanfar, MH, Alexander, L, Anderson, HR et al. (2015) Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386, 22872323.
2. Food and Agriculture Organization of the United Nations (2012) The Development of Global Diets Since ICN 1992: Influences of Agri-food Sector Trends and Policies. Rome: FAO.
3. Shaikh, AR, Yaroch, AL, Nebeling, L et al. (2008) Psychosocial predictors of fruit and vegetable consumption in adults: a review of the literature. Am J Prev Med 34, 535543 e11.
4. Fish, C, Brown, J & Quandt, S (2015) African American and Latino low income families’ food shopping behaviors: promoting fruit and vegetable consumption and use of alternative healthy food options. J Immigr Minor Health 17, 498505.
5. Diez Roux, AV & Mair, C (2010) Neighborhoods and health. Ann N Y Acad Sci 1186, 125145.
6. Swinburn, B, Kraak, V, Rutter, H et al. (2015) Strengthening of accountability systems to create healthy food environments and reduce global obesity. Lancet 385, 25342545.
7. Penney, TL, Almiron-Roig, E, Shearer, C et al. (2014) Modifying the food environment for childhood obesity prevention: challenges and opportunities. Proc Nutr Soc 73, 226236.
8. Zenk, SN, Schulz, AJ, Hollis-Neely, T et al. (2005) Fruit and vegetable intake in African Americans: income and store characteristics. Am J Prev Med 29, 19.
9. Caspi, CE, Sorensen, G, Subramanian, SV et al. (2012) The local food environment and diet: a systematic review. Health Place 18, 11721187.
10. Pessoa, MC, Mendes, LL, Caiaffa, WT et al. (2015) Availability of food stores and consumption of fruit, legumes and vegetables in a Brazilian urban area. Nutr Hosp 31, 14381443.
11. Costa, B, Oliveira, CD & Lopes, A (2015) Food environment of fruits and vegetables in the territory of the Health Academy Program. Cad Saude Publica 31, Suppl. 1, 159169.
12. Figueira, TR, Lopes, ACS & Modena, CM (2014) Avaliação do consumo de frutas e hortaliças entre famílias de usuários do Programa Academia da Saúde (PAS). Rev Bras Promoc Saude 27, 9.
13. Larson, NI, Story, MT & Nelson, MC (2009) Neighborhood environments: disparities in access to healthy foods in the US. Am J Prev Med 36, 7481.
14. Drewnowski, A, Aggarwal, A, Hurvitz, PM et al. (2012) Obesity and supermarket access: proximity or price? Am J Public Health 102, e74e80.
15. Gustafson, AA, Sharkey, J, Samuel-Hodge, CD et al. (2011) Perceived and objective measures of the food store environment and the association with weight and diet among low-income women in North Carolina. Public Health Nutr 14, 10321038.
16. Glanz, K, Sallis, JF, Saelens, BE et al. (2005) Healthy nutrition environments: concepts and measures. Am J Health Promot 19, 330333 ii.
17. Belon, AP & Nykiforuk, C (2013) Possibilities and challenges for physical and social environment research in Brazil: a systematic literature review on health behaviors. Cad Saude Publica 29, 19551973.
18. Duran, ACFL, Diez-Roux, AV, Latorre, MRDO et al. (2013) Neighborhood socioeconomic characteristics and differences in the availability of healthy food stores and restaurants in Sao Paulo, Brazil. Health Place 23, 3947.
19. Instituto Brasileiro de Geografia e Estatística (2016) Estimativas da população residente nos municípios brasileiros com data de referência em 1º de julho de 2015. http://www.ibge.gov.br/home/estatistica/populacao/estimativa2015/estimativa_tcu.shtm (accessed August 2016).
20. Ministério da Saúde, Brasil (2013) Portaria nº 2.681, de 7 de novembro de 2013. Redefine o Programa Academia da Saúde no âmbito do Sistema Único de Saúde (SUS). http://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt2681_07_11_2013.html (accessed May 2018).
21. Furey, S, Strugnell, C & McIlveen, H (2001) An investigation of the potential existence of ‘food deserts’ in rural and urban areas of Northern Ireland. Agric Hum Values 18, 447457.
22. Clarke, G, Eyre, H & Guy, C (2002) Deriving indicators of access to food retail provision in British cities: studies of Cardiff, Leeds and Bradford. Urban Stud 30, 20412060.
23. Smoyer-Tomic, KE, Spence, JC, Raine, KD et al. (2008) The association between neighborhood socioeconomic status and exposure to supermarkets and fast food outlets. Health Place 14, 740754.
24. Green, SH & Glanz, K (2015) Development of the perceived nutrition environment measures survey. Am J Prev Med 49, 5061.
25. Duran, AC, Lock, K, Latorre, MDRDO et al. (2015) Evaluating the use of in-store measures in retail food stores and restaurants in Brazil. Rev Saude Publica 49, 80.
26. Cannuscio, CC, Hillier, A, Karpyn, A et al. (2014) The social dynamics of healthy food shopping and store choice in an urban environment. Soc Sci Med 122, 1320.
27. Lee, RE, Heinrich, KM, Medina, AV et al. (2010) A picture of the healthful food environment in two diverse urban cities. Environ Health Insights 4, 4960.
28. Gustafson, A, Christian, JW, Lewis, S et al. (2013) Food venue choice, consumer food environment, but not food venue availability within daily travel patterns are associated with dietary intake among adults, Lexington Kentucky 2011. Nutr J 12, 17.
29. Segall-Correa, AM & Marin-Leon, L (2009) A segurança alimentar no Brasil: proposição e usos da escala brasileira de medida da insegurança alimentar (EBIA) de 2003 a 2009. Seg Alim Nutr 16, 19.
30. Centers for Disease Control and Prevention (2013) Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, GA: US Department of Health and Human Services, CDC.
31. World Health Organization (2016) The WHO STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance (STEPS). http://www.who.int/chp/steps (accessed February 2016).
32. Food and Agriculture Organization of the United Nations/World Health Organization (2004) Fruit and Vegetables for Health. Report of a Joint FAO/WHO Workshop, 1–3 September 2004. Kobe, Japan. Geneva: WHO.
33. Chow, CK, Lock, K, Madhavan, M et al. (2015) Environmental Profile of a Community’s Health (EPOCH): an instrument to measure environmental determinants of cardiovascular health in five countries. PLoS One 5, e14294.
34. Instituto Brasileiro de Geografia e Estatística (2010) Pesquisa de Orçamentos Familiares 2008–2009: Avaliação Nutricional da Disponibilidade Domiciliar de Alimentos no Brasil. Rio de Janeiro: IBGE.
35. Ministério da Saúde, Agência Nacional de Vigilância Sanitária (2002) Resolução de Diretoria Colegiada – Resolução RDC nº 275, de 21 de outubro de 2002. http://portal.anvisa.gov.br/documents/10181/2718376/RDC_275_2002_COMP.pdf/fce9dac0-ae57-4de2-8cf9-e286a383f254 (accessed May 2018).
36. Instituto Brasileiro de Geografia e Estatística (2014) Pesquisa Nacional de Saúde 2013. Percepção do Estado de Saúde, Estilos de Vida e Doenças Crônicas. Rio de Janeiro: IBGE.
37. Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância de Doenças e Agravos não Transmissíveis e Promoção da Saúde, Brasil (2017) Vigitel Brasil 2016: Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico: Estimativas sobre Frequência e Distribuição Sociodemográfica de Fatores de Risco e Proteção para Doenças Crônicas nas Capitais dos 26 Estados Brasileiros e no Distrito Federal em 2016. Brasília: Ministério da Saúde.
38. Ni Mhurchu, C, Vandevijvere, S, Waterlander, W et al. (2013) Monitoring the availability of healthy and unhealthy foods and non-alcoholic beverages in community and consumer retail food environments globally. Obes Rev 14, 108119.
39. Popkin, BM (2014) Nutrition, agriculture and the global food system in low and middle income countries. Food Policy 47, 9196.
40. Mendes, LL, Campos, SF, Malta, DC et al. (2011) Validity and reliability of foods and beverages intake obtained by telephone survey in Belo Horizonte, Brazil. Rev Bras Epidemiol 14, 8089.
41. Lopes, MS, Santos, LCd, Lopes, ACS et al. (2017) Comparison between two assessment tools for fruit and vegetable intake relative to the 24 h recall. Nutrition 38, 3840.

Keywords

Individual and food environmental factors: association with diet

  • Mariana Carvalho de Menezes (a1), Ana Victoria Diez Roux (a2), Bruna Vieira de Lima Costa (a1) and Aline Cristine Souza Lopes (a1)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed